Organ donation : supply, policies and practices / Petr T. Grinkovskiy, editor.

Format:

Book

Contributor:

Grinkovskiy, Petr T.

Language:

English

Subjects (All):

Donation of organs, tissues, etc--Government policy--United States.

Donation of organs, tissues, etc.

Donation of organs, tissues, etc--Law and legislation--United States.

Physical Description:

1 online resource (139 p.)

Edition:

1st ed.

Place of Publication:

New York : Nova Science Publishers, c2009.

Language Note:

English

Summary:

The issue of living organ donation is important because it represents one important set of possibilities for balancing the needs of people seeking organs with one another, and with the needs of potential organ donors. On one side of the balance, the drive to increase the supply of transplantable organs is fueled by people awaiting organ transplants. They are, in a sense, competing with one another on waiting lists for potentially life-saving scarce resources. On the other side of the balance, the drive to ensure that the transplant system is ethical and equitable precludes some mechanisms that would increase the supply of transplantable organs. Some options that have been rejected to date in the United States include paying healthy persons to donate their organs, and mandating that transplantable organs be harvested from all cadavers. To maintain the most ideal balance for the organ transplantation system, Congress may now wish to clarify whether certain new types of living organ donation should be adopted to increase the supply of transplantable organs, or prohibited for ethical and/or equitable reasons.

Contents:

Intro

ORGAN DONATION: SUPPLY, POLICIES AND PRACTICES

CONTENTS

PREFACE

Chapter 1 ORGAN DONATION: UTILIZING PUBLIC POLICY AND TECHNOLOGY TO STRENGTHEN ORGAN DONOR PROGRAMS*

BACKGROUND

CURRENT ACTIVITIES

FUTURE ACTIVITIES

Breakthrough Collaboratives

Scientific Registry of Transplant Recipients (SRTR)

Organ Donation Support

Public and Professional Education Programs

CONCLUSION

Chapter 2 INFORMATION POLICY, CENSUS, AND NATIONAL ARCHIVES SUBCOMMITTEE, OVERSIGHT AND GOVERNMENT REFORM COMMITTEE, "ORGAN DONATION: UTILIZING PUBLIC POLICY AND TECHNOLOGY TO STRENGHTHEN ORGAN DONOR PROGRAMS"∗

WHAT IS THE NATIONAL MOTTEP MODEL?

A 25 YEAR DATA ANALYSIS OF A NATIONAL DONOR EDUCATION PROGRAM

CADAVERIC DONORS PER 1,000 EVALUABLE DEATHS AND NUMBER OF DONORS BY ETHNICITY AND OPO'S, 1995-1998

NATIONAL MOTTEP'S PAST ACCOMPLISHMENTS

MOTTEP MILESTONES

I.A. 1991 - 1993

I.B. 1993 -1995

II. 1995 to 1999

Other "Firsts" Accomplishments Include (1993-1995):

MOTTEP OF HONOLULU - ACCOMPLISHMENTS

SUMMARY

Methodolgy

Results

Chapter 3 TESTIMONY BEFORE THE UNITED STATES HOUSE OF REPRESENTATIVES, INFORMATION POLICY, CENSUS AND NATIONAL ARCHIVES SUBCOMMITTEE, OVERSIGHT AND GOVERNMENT REFORM COMMITTEE, "ORGAN DONATION: UTILIZING PUBLIC POLICY AND TECHNOLOGY TO STRENGTHEN ORGAN DONOR PROGRAMS"*

THE BOTTOM LINE - SUPPLY DOES NOT MEET DEMAND

EDUCATION AND AWARENESS - PATIENTS &amp

PHYSICIANS

OUTREACH TO UNDERSERVED PATIENT POPULATIONS

ADDRESSING DISPARITIES IN SOLID ORGAN TRANSPLANTATION

REMOVING FINANCIAL DISINCENTIVES - FAMILY AND MEDICAL LEAVE POLICIES.

Chapter 4 STATEMENT BY SUSAN DUNN, ASSOCIATION OF ORGAN PROCUREMENT ORGANIZATIONS, DONOR ALLIANCE, INC., BEFORE THE INFORMATION POLICY, CENSUS, AND NATIONAL SUBCOMMITTEE ARCHIVES, OVERSIGHT AND GOVERNMENT REFORM COMMITTEE, SEPTEMBER 25, 2007∗

INTRODUCTION

THE CRISIS

EXTRAORDINARY RESULTS AND IMPROVEMENTS

A National Experiment

ORGANS RECOVERED AND TRANSPLANTED FOR EACH DONOR IS ALSO CRITICAL

THE 2006 REVISED UNIFORM ANATOMICAL GIFT ACT (UAGA)

DONORNET 2007

ORGAN DONATION AND RECOVERY IMPROVEMENT ACT

Chapter 5 TESTIMONY OF ELIZABETH M.P. RUBIN, BEFORE THE INFORMATION POLICY, CENSUS AND NATIONAL ARCHIVES SUBCOMMITTEE OF THE HOUSE OF REPRESENTATIVES ON OVERSIGHT AND GOVERNMENT REFORM COMMITTEE, SEPTEMBER 25, 2007∗

Chapter 6 INFORMATION POLICY, CENSUS, AND NATIONAL ARCHIVES SUBCOMMITTEE OVERSIGHT AND GOVERNMENT REFORM COMMITTEE, "UTILIZING PUBLIC POLICY AND TECHNOLOGY TO STRENGTHEN ORGAN DONOR PROGRAMS,"∗

Chapter 7 OPENING STATEMENT OF EVERSON WALLS, INFORMATION POLICY, CENSUS, AND NATIONAL ARCHIVES SUBCOMMITTEE, OVERSIGHT AND GOVERNMENT REFORM COMMITTEE ∗

Chapter 8 LIVING ORGAN DONATION AND VALUABLE CONSIDERATION*

ABSTRACT

Demand for Transplantable Organs

United States Organ Procurement System

Living Donation

Directed Living Donation and Valuable Consideration: Paired Donation and Other Types of Exchanges

IMPACT OF LIVING DONATION ARRANGEMENTS ON ORGAN SUPPLY

LEGAL ISSUES RELATING TO VALUABLE CONSIDERATION AND LIVING DONATION ARRANGEMENTS

Statutory Prohibition in NOTA

Valuable Consideration and Living Donation Arrangements

ETHICAL AND POLICY ISSUES RELATED LIVING ORGAN DONATION, AND PAIRED AND LIST DONATION

Evolving Transplantation Systems

Ethical Issues Related to Living Donation

Above All, Do No Harm

Risk-Benefit Ratios.

Informed Consent

Ethical Issues Related to List Donation: Blood Type O

Ethical Issues Related to Directed Donation (Paired and List)

Allocation

Parity

Ethical Issues Related to Proposals for Expanding the Organ Supply: Exchanging Valuable Consideration for an Organ

REFERENCES

Chapter 9 ORGAN TRANSPLANT PROGRAMS: FEDERAL AGENCIES HAVE ACTED TO IMPROVE OVERSIGHT, BUT IMPLEMENTATION ISSUES REMAIN*

WHAT GAO FOUND

WHY GAO DID THIS STUDY

WHAT GAO RECOMMENDS

ABBREVIATIONS

RESULTS IN BRIEF

Organ Transplantation Process

The OPTN's Role and Responsibilities

HRSA's Oversight of the OPTN

CMS's Role and Responsibilities

LIMITATIONS EXISTED IN FEDERAL OVERSIGHT AT THE TIME HIGH-PROFILE PROBLEMS CAME TO LIGHT

CMS's Oversight Was Limited and Inconsistent

CMS Did Not Actively Monitor Extra-Renal Transplant Programs

CMS Had a Process in Place to Monitor Renal Transplant Programs, but Some Programs Still Were Not Actively Reviewed

The OPTN's Oversight Was Active and Multipronged but Was Not Sufficient to Detect All Problems

The OPTN Actively Monitored for Many Types of Problems

The OPTN's Monitoring Did Not Detect All High-Profile Cases and Was Not Always Timely

CMS, HRSA, AND THE OPTN HAVE ACTED TO STRENGTHEN OVERSIGHT, BUT THE FULL EFFECT OF THESE ACTIONS WILL DEPEND ON IMPLEMENTATION AND FURTHER INFORMATION SHARING

CMS Strengthened Oversight by Expanding Monitoring Efforts and Issuing New Regulations

CMS Began Monitoring Extra- Renal Transplant Programs and Took Steps to Withdraw Medicare Approval from the Most Problematic Programs

CMS Established New Requirements that Apply to All Types of Transplant Programs

New Regulations Also Established Procedures for Reviewing Transplant Programs.

The OPTN and HRSA Have Taken Steps to Address Shortcomings in Detection of Problems

CMS, HRSA, and the OPTN Have Yet to Fully Implement Several Measures to Improve Oversight

CMS, HRSA, and the OPTN Are Sharing Basic Data on Transplant Programs, but How They Will Share Additional Information from Their Oversight Activities Has Not Been Resolved

CONCLUSIONS

RECOMMENDATIONS FOR EXECUTIVE ACTION

AGENCY COMMENTS

APPENDIX I: MEDICARE CONDITIONS OF PARTICIPATION FOR TRANSPLANT CENTERS

APPENDIX II: COMMENTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES

INDEX

Blank Page.

Notes:

Description based upon print version of record.

Includes bibliographical references and index.

Description based on print version record.

ISBN:

1-61470-483-X

OCLC:

759116926